Introduction: This study aimed to compare clinical and radiological outcomes of ATL and GTR. The primary endpoints were progression-free survival (PFS) and overall survival (OS). The secondary endpoints included postoperative morbidity, seizure-freedom, and cognitive performance.
Methods: This retrospective analysis included 39 consecutive patients who underwent surgical treatment for temporal GBM at Kantonsspital Aarau between January 2007 and December 2020. A total of 23 (59%) patients underwent ATL (ATL group) and 16 patients (41%) underwent GTR (GTR group). Survival outcomes including PFS and OS were also evaluated. Tumor characteristics, including volume, WHO grade, and molecular pathology, were assessed from radiological and molecular pathological findings. Clinical variables such as sex, age, preoperative and postoperative morbidity, postoperative Karnofsky Performance Status were assessed from the patients’ medical histories.
Results: No significant difference in PFS was observed between the ATL and GTR groups (HR=0.75, p=0.45). However, a trend towards prolonged PFS was observed in the ATL group. OS did not differ significantly between the two groups (HR=1.14, p=0.68). Postoperative morbidity and preoperative and postoperative seizures did not differ significantly (p >0.05) between the groups. Across the cohort, the median PFS was 10.3 months, and the median OS was 17.5 months. Tumors in the ATL group were significantly larger (p < 0.05) and more diffusely infiltrated (p=0.031) than those in the GTR group.
Conclusion : ATL appears to be a safe surgical approach for temporal GBM demonstrating a non-significant trend towards prolonged PFS, without significant differences in OS, seizure-freedom, postoperative morbidity, and cognitive performance, compared to GTR.
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